Worried by the increasing shortfall on Family Planning funding in the 2019 Budget, the Society of Gynaecology and Obstetrics of Nigeria (SOGON-PAS) with the support of development Research and Projects Center (dRPC), under the Partnership for Advocacy in Child and Family Health at Scale (PACFaH@Scale), organized a one-day mini-conference to discuss population control and reduction of maternal and child mortality rate in Nigeria through Family Planning (FP).
The theme of this conference was “Universal Health Coverage: Towards Reducing Maternal Mortality – The role of Child Spacing and Family Planning.” The conference was held October 3, 2019 at the NICON Luxury Hotel, Abuja
Objectives of the Mini-Conference
The objectives of the one-day conference were, to highlight Costs and Benefits of FP towards the reduction of the high maternal and new-born mortality in Nigeria. The conference aimed to bring to the fore the current and unacceptable shortfall in the 2019 FP budget, to discuss the implications of the shortfall of FP allocations on maternal health and maternal mortality, to draw government’s attention to the urgent need for investment in FP as a cost-effective method of reducing maternal and newborn mortality, and population control. Finally, the conference also aimed to find an alternative sustainable source of funding for FP.
Participants
About 102 participants with 37 females and 65 males attended the conference. Many relevant governmental and non-state organizations attended the one-day event. These include The Honourable Minister of Health, Dr. Osagie Emmanuel Ehanire, The Chairmen, Senate Committee on Health, Senator Yahaya Ibrahim Oloriegbe and House of Representatives- Committee on Healthcare services, Tanko Sununu, and officials of the Federal Ministry of Health (Family Health Division).
Others are representatives of the Federal Ministry of Budget and National Planning., the National Primary Health Care Development Agency (NPHCDA), and the National Institute of Legislative and Democratic Studies
The International organizations were represented by the World Health Organization (WHO) while religious organizations led by the representatives of the Sultan of Sokoto, Christian Associations of Nigeria (CAN)-Pastor Dr Peter Elemile, the Executive Secretary of National Inter-Religious Council-Fr. Prof Cornelius Omonokhua, the CAN Youth and Muslim Youths, FOMWAN were also present.
Professional Associations such as the Pharmaceutical Society of Nigeria (PSN) and the Pediatrics Association of Nigeria (PAN) also attended. Other nonprofits that attended were, the dRPC-PACFaH@Scale partners, such as the Medical Women Association of Nigeria (MWAN), the Society for Public Health Physicians of Nigeria (SPHPN), The Association for the Advancement of Family Planning (AAFP) and the National Council of Women Societies of Nigeria (NCWS)
Other International NGOs that attended were (Family Planning Country Action Process Evaluation-FPCAPE, CHAI, MSI, Pathfinder, FHI 360, PSI) while Indigenous NGOs such as HVN, HERFON, and PPFN were in attendance. SOGON-PAS CSO Coalition Members (Balanced Stewardship Development Association, Adolescent Care Support and Empowerment Initiative, Basic Health Foundation, Better World Initiative, Citizens Health Education and Development Initiative, Education as a Vaccine, Entrepreneurship Development and Support Initiative , Esther Tsee Foundation, Family Holistic Care Foundation, Foundation for Family Values and Health Orientation and Empowerment, Heal the Youth Foundation, Majesty Community Rural Development Foundation, Nigerian Women Agro Allied Farmers Association, Ummah Support Initiative, Traffina Foundation for Community Health, Positive Care and Development Foundation, Greater Life Initiative, and First Initiatives were all present
Welcome address
In his welcome address, The President of SOGON, Professor Oluwarotimi Ireti Akinola, highlighted the unacceptably high maternal mortality statistics in Nigeria. He stated that despite the various high-level commitments made by the Federal Government of Nigeria and the efforts by partners, there seems to be no meaningful improvement in the modern Contraceptive Prevalence Rate (mCPR) in Nigeria. Professor Akinola said that it is almost not feasible for Nigeria to achieve the FP 2020 target of 27% if it took the country 2013 to 2018 to move from 10% to 12% mCPR. He emphasized that the fertility rate of Nigeria is 5.5% and population growth rate is 3.1%, which invariably means that the country is reproducing faster than its resources.
Professor Akinola stated that Nigeria is the world’s poverty capital because she is bringing forth children without plans to sustain them.
Goodwill messages
International Organizations and other partners at the event expressed their commitments to working together with other relevant stakeholders to close the funding gaps in family planning financing in Nigeria.
In his speech, the Senior Program Officer-Pathfinder, Dr Kenny Ewulum, thanked the dRPC/SOGON-PAS team for organizing such a unique conference to address issues around maternal and newborn health and that Pathfinder is happy to partner with SOGON. He stated that it was critical for Nigeria to move faster and change the status quo by doing things differently. Dr. Ewulum said Pathfinder was pleased to see the conference emphasize the relationship between child spacing and the unacceptably high maternal mortality in Nigeria. He concluded that Pathfinder International shares the vision of SOGON for Nigerian women and emphasized the need to also prioritize discussions around the girl-child education in Nigeria.
Dr. Muyiwa Ojo (NPO, MSRH WHO) stated that WHO was very pleased to see the discussion with key stakeholders involved in the conference, noting that the WHO’s mandate is for Universal Health Coverage which includes family planning.
Keynote address by the Honorable Minister of Health
In his keynote address, The Minister of Health Professor Osagie E. Enahire, who was represented by the Director of Family Health Division-FMOH, Dr Adebimpe Adebiyi, stated that “Universal Health Coverage is anchored on the fact that health is a human right, particularly the health of women and the girl child. “Considering the theme of the conference, there is a need for a robust understanding of the FP intervention so as to improve FP services as a one-way ticket to fight overpopulation”, he added
The Minister said that the government is making efforts in repositioning FP interventions in the country and appropriate step is being taken for the uptake of an affordable collaboration for Modern Contraceptive Prevalence with other partners working in the area of FP in the country”.
“The Federal Ministry of Health is currently planning to establish an FP 2020 secretariat to handle supports and counterpart funding for the procurement of FP services, and has been mobilizing resources for FP over the years and 2019 is not going to be an exception.
Presentations
In his presentations on the implication of Family Planning to health and development, Professor Oladipo Otolorin, (SRR/Technical Advisor, Jhpiegho), who is also a prominent member of SOGON said that it is depressing that Nigeria is yet to make a significant effort as per population control or the burden of maternal mortality. He disclosed that, for every five women that die globally during childbirth, one is a Nigerian. This implies that Nigeria contributes 19% of maternal death, despite being only 2.5% of the global population. In 2017, he said, of the 196,000 maternal deaths that happened in Sub-Saharan Africa, 67,000 are from Nigeria. He acknowledged that efforts have been made by the country to reduce maternal mortality from 870/100,000 in 1990 to the current figure of 5776/100,000 Live births. This he said, brought about steady progress in reduction of child mortality due to increased immunization efforts in the past 5 years.
On Population growth, he pointed out that Nigeria’s population is over 200 million as the seventh most populous country in the world with population growth rate of 2.6%. He noted that with with this trend, Nigeria may become the third most populous country in the world by 2050, overtaking the USA and Russia. Unfortunately, 44% of Nigeria’s population is below age five and fall within the dependent group. He stressed that countries like China, India, and Thailand have improved their mCPR, by making strong decisions and policies about population control.
Professor Otolorin stated that if Nigeria does not embrace FP, the country may not make progress in improving citizens’ standard of living. He stated that FP helps to manage population growth, reduce the risk of maternal death during childbirth, and reduce the spread of HIV and other sexually transmitted diseases. Pointing to Iran, Egypt and Brazil with fertility rates of 1.9, 3.0 and 2.5 respectively, Professor Otolorin wondered why Nigeria could not follow the footsteps of such religious countres. He stressed that FP has been known to reduce maternal mortality by 46%.
Presentation 2:
FP funding Commitment for the attainment of FP2020 targets in Nigeria
In his presentation on family planning funding commitments for the attainment of FP2020 targets in Nigeria, the SOGON-PAS Project Director, Dr. Habib Sadauki said that the chances for Nigeria to achieve its 2020 FP commitment and targets are very slim. He pointed out that Nigeria in 2017 during the London summit committed to achieve mCPR of 27% by 2020. However, despite her efforts, Nigeria is still very far from reaching its 2020 target.He decried the fact that only 300 million Naira was allocated for FP in the 2019 Federal Government budget, against the advice by Bill and Melinda Gates Foundation on the urgent need to improve domestic funding for family planning. Dr. Sadauki called on the government to urgently provide a supplementary budget for FP interventions. He also stressed the need for more domestic funding for family planning from both Federal and State governments while advocating the involvement of the private sector in improving the mCPR in Nigeria.
Panel discussion on FP funding in Nigeria: Religious and Traditional Perspectives
The CAN President, represented by Pastor Dr. Peter Elemile said that the Bible is in support of measures that enable good family health. He advised Nigerians to have children they can train and cater for, noting that CAN is actively involved in advocacy for child spacing, is in partnership with government and other organizations on child spacing, and is willing to continue to partner with advocates for increased funding for FP.
The Sultan of Sokoto, represented by Dr. Luka Panya, the Esu of Karu, said traditional rulers have an important role to play in ensuring Primary Health Care (PHC) delivery. He said that the Sultan of Sokoto had constituted a committee to create awareness on modern contraceptives use in Nigeria and pointed out that the committee has engaged the community -based data collation on FP in the northern states including the federal capital territory (FCT).
In her remarks, The President of National Council for Women Society – Dr. Mrs Gloria Laraba Shoda (MNI) shared her experiences of having her first child in her early teens. She said family planning assisted her to avoid having many children. Dr. Shoda pointed out that many women want family planning services but cannot because they don’t get support from their husbands. She said that NWCS has programs in schools and churches to create awareness of contraceptive use. She advocated for improved education, introduction of mentor to children on unwanted pregnancies and increased awareness on child spacing in Nigeria. Dr. Shoda advocated accountability and effective utilization of funds in Nigeria’s health system.
While describing Nigeria as having a demographic crisis, Dr. Ejike Orji (AAFP) said there is a need for strategic planning to ensure strategic procurement of commodities and services. He further stated that the population explosion has led to youth bulge, high level of emigration, and killings. He then identified low hanging fruits and opportunities to finance family planning services in Nigeria such as the National Health Act through Basic Health Care Provision Funds. The World Bank funding for Save One Million Lives project is also an avenue for funding FP. He mentioned the dwindling budget allocation to family planning suggests the need to recruit for legislators as partners in family planning efforts.
The Deputy Chairman House committee on Health Dr. Babatunde Adejare the representative of the Chairman House committee on health, blame culture and religion as the main challenges militating against improving Nigeria’s Modern contraceptive prevalence rate. He, therefore, urged the religious and traditional leaders to speak up and address the rejection of Family Planning in their various communities.
Dr. Adejare stated that the National Assembly is proposing a bill to establish Health Bank in Nigeria that will support loans for health sector investment to drive the private sector to be very productive. He pledged that the House of Representatives in the 9th National Assembly will look at the challenges of FP in the previous years and proffer solution. Dr. Adejare also hinted that the National Assembly intends to have a robust retreat with the Federal Ministry of Health to address the national FP funding and implementation issues.
Mr. Tajudeen Arowole, who represented the Senate Chairman Committee on Health, Senator Ibrahim Yahaya Oloriegbe, said the National Assembly is looking at improving funding for FP and prioritize FP appropriations.
Vote of thanks
Vote of thanks was given by the Secretary General of SOGON, Dr Chris Aimakh, who acknowledged the positive participation of all the dignitaries present and thanked them for attending. The event came to an end with the recitation of the first stanza of the National anthem at about 02:38 pm.
Outcomes of the Conference
The conference achieved the following:
∙ Created awareness on the shortfall in 2019 FP budget and the need to pay attention to the 2020 budget
∙ Obtained commitments from high ranking members of the National Assembly (Senate and House of Representatives) Committees on Health for increased funding of Family Planning services, products and programs in Nigeria.
∙ The Honourable Minister of Health, Dr. Osagie Ehanire committed to ensuring resource mobilization for FP in Nigeria.
∙ The representatives of the two dominant religions (Islam and Christianity) in Nigeria who spoke at the convening committed to supporting mobilization of resources for family planning in Nigeria
∙ The Civil Society, Youth and Women Groups pledged at the end of the event to continue advocating to the government and other relevant stakeholders to ensure prioritization of FP in Nigeria.
The Next Steps
∙ Regular follow -up with the Chairman House Committee on Health to ensure the issue of FP funding gap is addressed
∙ Advocacy visit to the Minister of Health to present funding gaps and gain more commitments towards FP interventions.
Cross section of participants during the mini-conference organized by SOGON-PAS
